- You've heard
about the transitional care management program
but you might be wondering
whether or not it's a worthy investment
of your time and resources to offer at your practice.
In this video we're going to break down
the return on investment for Transitional Care Management
to understand the cost and reimbursements
of this valuable program.
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Hi, this is Loran with ThoroughCare.
Every day at ThoroughCare
we're helping groups like yours to help manage,
streamline and bill for value based programs,
such as Transitional Care Management.
Running a TCM program can be extremely beneficial
to your patients, your practice,
and affect your bottom line.
In just a few moments we're going to discuss
the reimbursement opportunities of this program,
how this program can help cut costs
and also directly affect
the value based reimbursements at your practice.
However, if you'd like to learn
more about the transitional care management program
as a whole before viewing this video,
check out the link above.
Let's first start with looking
at the revenue opportunities available with TCM.
With this ROI example
we're going to take a look
at a moderate complexity TCM billing using CPT code 99495
with a face to face visit
occurring within the first 14 days of discharge.
CPT code 99495 has a national average reimbursement rate
of $176.50 monthly.
That means if 10 patients receive
moderate complex TCM per month,
that's about $1,765 in monthly reimbursement.
Overall that comes to $21,180 in annual reimbursement.
So what are your costs of running a TCM program?
Keep in mind these numbers don't account for staff wages.
However, it is likely you're already doing the work
that is inherent to complete the TCM.
Also, we did not look
at the high complexity Transitional Care Management code
which could produce a higher reimbursement.
A high complexity TCM
is dependent on the medical decision making
it takes to complete the TCM.
If you'd like to learn more
about complexity in medical decision making
there is a link below to our learning center
where you can learn more about complexity
and the transitional care management program.
So how else does a TCM program improve revenue?
By cutting patient costs.
While the phrase return on investment
usually holds a financial connotation,
this return isn't dependent on financial value.
General benefits are equally important
especially with regard to a person and their health.
Patients benefit from TCM for its attention to their health
at critical junctures.
Patients usually decrease their odds
of hospital readmission
when they participate in this program.
Offering these services can recover costs
and standardize certain processes.
This will make them more valuable to your patient.
On the provider side
this program plays right to the goal of value-based care.
Reduced readmissions help satisfy
certain performance indicators measured by Medicare.
This can help providers sustain or improve their MIPS scores
which can raise reimbursement rates.
As you can see the program more than pays for itself.
So now that you have a better understanding
of Transitional Care Management's return on investment
maybe you'd like to add this service
to your practice or add it to an already existing
care management program you are offering.
If you're interested in care coordination software
and how ThoroughCare can help, reach us at the link below.
Don't forget to like this video and comment
if you have any questions.
Thanks for watching and we hope to hear from you soon.
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